Forearm transaxial compression band

ABSTRACT

An adjustable strap or band adapted to be circumferentially fitted around the forearm to alleviate the symptoms of tennis elbow. The strap is a generally band-shaped device having opposing inwardly protruding means on its forearm contacting surface to direct transaxial compression against the radial extensor, supinator complex and flexor muscles when the band is circumferentially tensioned and fastened in place around the forearm. In its preferred form, the band applies an adjustable pressure principally upon the extensor, supinator and flexor wads permitting unimpeded blood circulation along all other portions of the forearm. The two opposing means for applying transaxial compression are limited in their circumferential extent to those areas of the band immediately overlying the extensor and flexor muscle mass.

This is a continuation of application Ser. No. 07/806,863, filed Dec.12, 1991, now abandoned which is a continuation of Ser. No. 07/744,871,Aug. 14, 1991, now U.S. Pat. No. 5,152,302.

BACKGROUND OF THE INVENTION

1. Field of the Invention

The present invention relates generally to an adjustable compression armband and, more specifically, to an arm band constructed to be worn bypersons suffering from symptoms of lateral epicondylitis (tennis elbow),radial supinator syndrome and medial epicondylitis.

2. Prior Art

Tennis elbow, sometimes referred to in the prior art alternatively aslateral epicondylitis or epicondylalgia externa, is frequently found inmen and women between the ages of thirty and fifty who engage in racketsports. In people in the aforesaid age group, muscles and tendons becomeless supple and less able to absorb and dissipate the forces associatedwith sudden acceleration and deceleration which cause the inflammationassociated with tennis elbow particularly where the extensor muscle massmeets the bone. Tennis elbow is also found in individuals pursuingactivities such as golf and bowling. It is also found in certain tradessuch as carpentry, due to repeated hammering and driving of screws, andhouse painting, due to the forward and backward stroke of the brush.

Although "tennis elbow" is frequently thought of as an inflammation ofthe extensor muscles of the forearm, such inflammation may beaccompanied by radial supinator inflammation due to repetitive pronationand supination. Such inflammation of the supinator muscle mass can causetension on the overlying extensor muscle and resultant inflammation. Theforearm extensor and supinator muscles are those that come into playduring the extension, raising or snapping of the wrist. Every time atennis ball hits a racket, there is a certain force or mechanical shockwave propagated up the forearm muscles which are already in tension dueto the weight and acceleration of the racket and the tension caused bythe centrifugal force of the stroke. If the ball is mis-hit, an extraforce is added resulting in a snap of the wrist. It is this extrarepetitive stress that causes the trauma leading to inflammation in theextensor and supinator muscles.

Prior art devices and procedures to control "tennis elbow" have beenprincipally directed to lateral epicondylitis due to inflammation of theextensor muscle mass. Such devices include tension bandages for supportand non-elastic bandages which are fastened around the forearm toinhibit the massive movement of the extensor and flexor muscles andabsorb much of the shock. The following United States patents describesuch devices and are made of record: U.S. Pat. Nos. 4,628,918;4,905,998; 3,970,081; and 4,191,373.

Applegate, Jr., in U.S. Pat. No. 3,970,081 (referenced above) describesa support to be worn on the arm near the elbow joint for reducing painin the elbow joint associated with the condition of tennis elbow.Applegate, Jr.'s strap comprises a tubular sleeve of one-way stretchfabric with an integral non-elastic strap. In use, the tubular sleeve ispulled up over the arm and positioned. The strap is tightened tocompress a disc housed thereunder causing the disc to press against theforearm. Applegate, Jr. teaches positioning the tubular sleeve such thatthe compression disc underlying the inelastic band may be positioned onthe arm wherever it will provide or afford the most relief. TheApplegate, Jr. sleeve and integral band is substantially circular andbecause it is circular, it applies pressure substantially evenly aboutthe forearm thereby impairing the circulation much like a tourniquet. Itis, therefore, desirable to provide a pressure band similar toApplegate, Jr.'s without the disadvantage of impairing blood circulationin the forearm.

Each of the aforesaid patents provides for a device to relieve thesymptoms of lateral epicondylitis. Each of the devices stresses eitherabsorption of shock and vibration or the application of warmth or heatand pressure. None of the devices addresses the associated problems offlexor and supinator muscle inflammation or the problem of impeded bloodcirculation due to compression of non-target tissues in the forearm orupper arm. It is, therefore, desirable to provide a compression banduseful for treating the symptoms of tennis elbow whether due toextensor, flexor or supinator inflammation. Additionally, the design ofthe band should minimally impair normal circulation up and down the arm.

SUMMARY OF THE INVENTION

The invention provides an adjustable band to be worn by an athlete orsomeone suffering from the symptoms of tennis elbow comprising a meansfor applying transaxial pressure selectively to the extensor, flexor andsupinator muscles of the forearm and, at the same time, notsubstantially compressing non-target tissues of the forearm. In thisregard, it is helpful to consider the cross-sectional geometry of theforearm. In cross-section, the forearm is not round, it is elliptical. Acircular compression strap (such as those described in the prior art)placed around the forearm will compress the greater diameter of theellipse more than other areas of the circumference. In other words, acircular strap provides the greatest compression at the greatestdiameter of the ellipse. Depending on the anatomy of the individual, theportions of the forearm circumference at the greatest diameter may notoverlie the inflamed muscle masses associated with tennis elbow. Such aprior art band would merely function as a tourniquet to impede bloodflow up the arm. It is, therefore, an object of this invention toprovide a compression band for use on the forearm which will applytransaxial compression selectively to the flexor, extensor and supinatormuscle masses in the forearm without substantially compressingnon-target tissues.

It is still another object of this invention to provide a compressionband for use around the forearm comprising an inelastic eccentric strapwith discrete, elastic inwardly protruding means on theforearm-contacting surface of the strap for selectively pressing againstthe flexor and extensor muscles.

Another object of this invention is to provide a forearm compressionband with means on the inner surface thereof for selectively applyingtransaxial countercompression against an anatomically opposed pair oftarget tissues such as the extensor and flexor muscle wad where saidcountercompression means may be easily adjusted by the user while inuse.

These and other objects of the invention will soon become apparent as weturn now to the drawings.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a longitudinal cutaway section of a forearm showing theextensor and flexor muscles and epicondyle.

FIG. 2 is a transverse cross-sectional view of the forearm along line2--2 of FIG. 1 showing the extensor, flexor and supinator muscle wads.

FIG. 3A is a schematic view of an inflamed muscle and epicondyle in arest position.

FIG. 3B is a schematic view of the muscle of 3A showing the increase inlength resulting from an applied pressure.

FIG. 4 is a view of the transaxial compression arm band showing the armband circumferentially positioned around an arm.

FIG. 5 is a front view of the arm band of FIG. 4.

FIG. 6 is a perspective view of the transaxial compression band of thepresent invention.

FIG. 7 is a cross-sectional view of the transaxial compression bandaround the forearm.

DESCRIPTION OF THE PREFERRED EMBODIMENT

FIG. 1 is a cutaway view of the forearm generally indicated at 10showing the extensor carpi radialis brevis muscle wad 11 and theextensor carpi radialis brevis muscle wad 13. The lateral epicondyle isindicated at the numeral 12. The extensor radialis muscle groups 11 and13 "or wads" are elongate more or less sausage shaped muscles enclosedin a fascia.

The cross-section of the sausage-shaped flexor and extensor muscles isshown in FIG. 2. The radial supinator complex 22 surrounds the radius 21and directly underlies the extensor muscles 11 and 13. As used herein,the term "transaxial compression" or alternatively, "transaxialcountercompression," refers to opposing pressure applied across theforearm in the general direction of the two broad arrows. Transaxialcompression is the bipolar compression exerted, as for example, by a "c"clamp, to anatomically opposed target muscles underlying the skinwithout substantially compressing non-target tissue. The magnitude ofthe pressure applied to anatomically opposed target muscles is equal butthe direction of the pressure is in opposition. Transaxial compressionis similar to placing a forefinger over the extensor muscle of theforearm and a thumb over the flexor muscle and pinching. It is seen thatsuch transaxial compression countercompression will simultaneouslycompress the extensor muscles 11, 13 and the underlying supinator muscle22 and the opposing flexor muscles 23 and 24 adjacent to the ulna 25without compressing other non-target tissues.

Turning now to FIG. 3A and B, an inflamed arbitrary muscle, for example,the extensor carpi radialis brevis "wad" is shown. FIG. 3A depicts thewad under tension having tenderness resulting from inflammation of themuscle near its point of insertion on the lateral epicondyle 12. Thetenderness is aggravated by tension on the wad as occurs during movementof the wrist. In such a case, the length of the wad is shortened causingstretching of the wad at the lateral epicondyle and pain. In FIG. 3B,the wad is compressed at a point 31 along its length. Since the wad isenclosed in a fascia and is substantially noncompressible, thecompression causes the muscle wads resting length l to increase to a newlength l' where l' is greater than l. Lengthening the muscle wadgenerates slack therein and relieves the tension at the point ofinsertion with concomitant relief of the associated pain.

It is important to note that the forearm is substantially elliptical incross section. A circular band applied o he forearm for the purpose ofapplying pressure to the wad will preferentially apply pressure at thegreatest diameter of the ellipse thereby compressing the underlyingblood vessels and impeding blood circulation. It is, therefore,desirable to provide the encircling portion of the compression band withan asymmetry such that only the flexor, supinator and extensor musclesare substantially compressed by the band.

Such an asymmetry is shown generally in FIG. 4 and in more detail in thepreferred embodiment shown in FIG. 5. In FIG. 4, a band 50 is shownencircling the forearm 40. The band 50 has inner skin contactingsurfaces 41 with discontinuities at 42 and 43. The positions of thediscontinuities are such that they overly the non-target tissues tominimize pressure thereon. When in use, the encircling band may bepositioned about the forearm to align the discontinuities 42 and 43 tooverlie the non-target tissues of the forearm. The two opposingprotuberances 44 (only one is shown in FIG. 4) may then be positioned tooverly the extensor and flexor wad and the band tightened. The presenceof a plurality of discontinuities about the inner circumference of theband will enable unrestricted circulation of the blood and enablecompression of a selected muscle group.

A particularly preferred embodiment of a compression band according tothe teachings of the invention is shown in FIG. 5. The band, generallyindicated at 50, has a skin contacting pad 53 and at least oneinflatable balloon-like skin-contacting member 55 disposed on its innersurface. A pump 51, which preferably may be operated by finger pressure,is mounted on the outer surface of the band. The pump 51 is in fluidcommunication with the interior of the inflatable member by means of achannel 52 permitting adjustment to provide the desired pressure againstthe underlying muscle group.

The construction of the band 50 is specially adopted to providetransaxial countercompression. The band 50 comprises two substantially"U" shaped inelastic plates: an upper plate 56 and a lower plate 57linked to one another by one or more adjustable straps 58. In thepreferred embodiment, the inner skin contacting surface of the upperplate 56 comprises one or more inflatable elastomer balloons 55, thepressure within the interior chamber of the balloons being adjustable bymeans of a finger-activated pump/exhaust 51. The skin contacting surfaceof the lower plate 57 is conveniently lined with a closed cell foam 53for comfort. When the strap 50 is securely fastened around the forearmwith the opposing skin-contacting surfaces 53 and 55 overlying theextensor and flexor muscles, inflation of the balloon(s) 55 by means ofthe pump 51 draws the lower plate 57 toward the upper plate 56 therebyproviding transaxial countercompression of the flexor, supinator andextensor muscles.

The transaxial compression is seen more clearly in FIG. 7. The flexormuscle mass 72 is located adjacent to the ulna 71. The extensor musclemass 74 lies adjacent to the supinator complex 75 which, in turn, liesadjacent to the radius 73. It is clear that counter compression of theupper and lower plates in the direction of the heavy arrows willcompress the flexor, extensor and supinator muscles.

As mentioned earlier, an advantage of using the present transaxialcompression band is that it is useful for treating medial epicondylitisand radial supinator syndrome as well as lateral epicondylitis. Even ifthe patient does not have these complaints, the band will have littleadverse effect on circulation. Prior art devices rely on tightening astrap to apply significant compression deep to the muscle. Such pressurecauses the veins to distend and impedes circulation. The transaxialcompression band minimizes the tourniquet effect. In addition, If theunderlying tissue is inflamed, holding transaxial compression on themuscles during exercise helps squeeze fluids from the inflamed tissueand mechanically decrease the associated swelling.

It is to be understood that numerous modifications may be made in theillustrated preferred embodiment and other arrangements may be devisedwithout departing from the spirit and scope of the invention as setforth in the appended claims.

What I claim is:
 1. A method for treating the symptoms of tennis elbowcomprising the following steps:a) presenting a generally circular devicethat comprises a means for concentrating a radially compressive forceonto the forearm, the means for concentrating the force are two surfacesprojecting inwardly from the circular device and located at two distinctpositions that are transaxially opposed from each other; b) placing thedevice around the forearm to encircle at least a portion of the forearm;c) applying bipolar transaxial compression of equal magnitudesinmultaneously to discrete areas of the skin directly overlying theflexor and the extensor muscles of the forearm without substantialcompression of other skin of the forearm.